Aseptic catheter-handling device



July 30, 1935- R. H. WAPPLER ASEPTIC CATHETER HANDLING DEVICE INVENTOR,I M11. Wa alfl/l; BY W A TTO NE) Filed April-Z6, 1935 NI-TEDYSTATPatented July 30, 1935 PAT ASEPTIC CATHETER-HANDLING DEVICE Reinhold H.Wapplcr, Yonkers, ,Frederick C. Wappler esecutor of said Reinhold H.Wappler,

deceased Application April 3, 1933, Serial No. 664,165

14 Claims. (01. 128-349) I My present invention relates generally tosurgical instruments, and has particular reference to the manipulationof catheters. a

. One of the most difficult problems inurology is the sterile handlingof ureteral catheters dur ing the process of catheterization. 'The'factthat .these catheters are inserted deep intothe body,

and are in many cases-employed for the purpose'of withdrawing a-truespecimen from the ureters or kidneys, makes it essential that thegreatest care be taken in maintaining the catheters in sterilecondition, both exteriorly andinteriorly, not only for the purpose ofpermitting a Wholly uncontaminated specimen to be withdrawn, but also toprevent accidental infection.

The delicate structural characteristics of a cath-etencoupled with itsrelatively great length, makes it particularly difficult to maintain thecatheter in a wholly sterile condition during the process of insertion.The catheter is usuallyinserted into position through a catheter=tunnelforming part of a suitable endoscopic instrument, the instrument beingprovide-d with illuminating and telescopic means to permit the operator.to control the movements of the catheter under illuminated vision. Aninstrument of this character is also usually provided with deflectingmeans which are controllable by .the'operator to guide the, forward endof the catheterinto the proper directions. With his eye glued to theeyepiece of the telescope, and with his mindoccupied with the propercontrol of the catheter by the deflecting means, it is'necessary for theop- 'erator at the same time to advance the catheter from the rear, step'by'step, through theinstrument. Not only does this entail'repeatedundesirable grasping of the catheter itself by the hands of theoperator, but it frequently happens that the catheter brushes againstthe face of the operator or against the body ,ofthe patient.

Whilethe. procedure is not essentially a diilicult one, it is obviouslyone whose technique has not been developed, heretofore, .to :athoroughly aseptic degree.

It is a general object of my present invention to provide a. means forfacilitating an aseptic and sterile manipulationof the catheters ingeneral, and especially a procedure of the foregoing character.

It is a more particular object of my] invention to provide an improvedcatheter-handling device,

of sterilizable characteristics; ,Whioh may be efficiently employed foraseptically 'effectingfan insertion of a catheter into the into one-orthe other of the ureters; r

human body, e. g,

My present device consists, briefly'and essentially,;of an elongated,flexible, 'sterilizable tube adapted to accommodate the rearward portionof the catheter, thereby protectively enclosing the latter, incombination with a catheter-grasping member carried or mounted at theforward end of thetube and adapted to releasably engage theforwardlyprojecting portion of the catheter.

From one'aspect, the elongated, flexible tube constitutes by itself animportant novel feature of my present invention. The tube is preferablyof 'softrubber, of sufficient length to accommodate the entire cathetertherein, and of a crosssectional size-which efficiently ensheaths thecatheter yet permits it to be loosely accommodated soas to belongitudinally movable.

Another feature of myinvention lies in the association, with a tube ofthe foregoing character,

of acatheter-grasping member which is easily :manipulable by theoperator to effect an aseptic grasp and release of the catheter.

In a preferred embodiment, the grasping member is mounted forlongitudinal reciprocation along a direction which forms a smoothcontinuation -of theaxis of the tube, thereby permitting a step-by-stepadvancement of the catheter in a forwardly longitudinal directionwithout any danger of kinking the catheter. A' particular feature ofmyinvention lies in providing an efficientiand improved guiding means forthe graspingmember, whereby its reciprocal movements are constrained:toa predetermined direction.-

iIn.the pr.efer'red construction hereinbefore alluded to, I also providea means for securing the presentdevice, forwardly of thecatheter-grasping member, to the rear end of a' catheter tunnel. Inanother embodiment, the catheter-grasping member *is, of simplerstructural nature and is associated with the forward end of the tube soas to be manipulable, by means of finger grips, toreleasably grasp thecatheter, but without being itself longitudinally reciprocable relativeto the tube. g

In general, my present device is one which'is simple in structuralnature, inexpensive to manu- 21, isdisposed in the ner in which a deviceof the present character is associated therewith;

Figure 2 is a side view of a portion of the present device, partly insection;

Figure 3 is a plan view of Figure 2;

Figure 4 is an enlarged cross-sectional view taken substantially alongthe line 4-4 of Figure 2;

Figure 5 is a view similar to the manner of use;

Figure 6 is a side view of a modified construction;

Figure '7 is a plan view of Figure Q; and

Figure 8 is a cross-sectional View taken substantially along the line 8--8 of Figure 6.

The endoscopic instrument of Figure 1 is merely illustrative of the typewhich may embody a catheter tunnel and which'n ay be. employed 10); thepurpose of inserting a catheter into one of the ureters. The illustratedendoscope 10 has a lateralfenestra H, and an illuminating lamp I2 ismounted at the forward end. A telescope I3 is associated with theinstrument and is provided with the usual eyepiece l4 and with a forwardV objective lens (not shown) which coinmands a view out of the fenestral I. ment I'have shown is also provided with a deflector I 5 which iscontrolled from the rearward Fi r ho in portion of the instrument by therotatable knob [6. Rotation of this member causes the deflector toassume positions of varying obliquity, whereby the deflector is causedto bear downwardly upon the forward end of a catheter I1 and therebyguide the latter into the proper direction.

The instrument is provided with a catheter tunnel l8 whose rearward endis shown at [9 in Figures 1 and 2. The forward end of this tunnel is inthe tube l0 near the fenestra ll, so that a catheter pushed through thistunnel from the rear will emerge through the fenestra II and in aposition ready to be acted upon by the deflector [5. Y

The present device consists ofan elongated, flexible tube 20, preferablyof rubber, and of sufficient length to accommodate almost the, entirecatheter I! when, the latter is in its retractedposition. Since thecatheter of Figure l is shown partly projected from the fenestra l- I,the rear end midportion of the. tube 20.. Before the catheter isinserted into the tunnel la, the, rear end is positioned in the tubenearer to the rear end'22 of the. latter.

I have. illustratively shown the rear end 2| of the. catheter I! pluggedwith a device 23 of the. character illustrated and described in mypatent application Serial Number 543,081, new Patent No. 1,906,678,dated May 2, 1933, although, obviously, the. employment of thisplugging. device is not essential.

The. forward end of the tube 20. is mounted on a nipple 24. whichispreferably in screw-threaded engagement with the rear arm 25. of thedevice shown most clearly in Figures 2 and 3. Projecting. forwardly fromthe. arm. Z5v is the squared metallic guide. rod 26; and at the forwardend of the latter is a means for attaching the. device to the rear end[9. of the tunnel I8. I have illustratively shown a disc-shaped endmember 21., preferably knurled on its periphery, and. provided with theforwardly projecting, slightly'tapered nipplev 28. On; the rear ofthemember 2'|.'is another nipple .29; upon whichv I M ier. to mount arubber sleev 3!].

he parts r o co s r cted. a d arr nsedthat be 11: 6 aral e utoflse rmiihc idsoi provide a direction of the axis of The instru the tube 20,and the nipple 29 is lined up with the nipple 24, and hence with theaxis of the tube 20.

Slidably mounted on the rod 26 is the cathetergrasping device whichconsists of a sleeve 3| encircling the rod 26, and a pair of depending,resilient, metallic arms or jaws 32. These arms preft b y term nate atheir re lower edges in the k u l d ng r n 1- On the inner surfaces ofthe members 32 I pair of opposed complementary grasping jaws 34 whichare somewhat elongated in the the device, and are of concaveconfiguration so as to conform substantially to the cross sectionalcurvature of the catheter t1, shown most clearly in Figures 4 and 5.

Inthe device illustrated, the resilience of the jaws lgeeps themnormally in spaced relationship, on opposite sides of the catheter l1,whereby a slight pres nrcbyth thumb and forefinger of the operator(indicated by the reference numerals 35 and 3B in Figure 5,) willsqueeze the jaws together to eifect a releasable grasp of the catheter.

In use, the. catheter is first threaded into. the tube 2a through theforward end thereof, so that only the forward portion of the catheterprotrudes. The entire assembly, from the nipple 28 rearwardly, may thenbe sterilized by boiling or otherwise. The entire assembly may then beremoved from the. sterilizing chamber without any danger ofrecontaminating the catheter, either exteriorly or interiorly, since thelatter is. protectively enclosed by the tube 2.0. A convenient grasp maybe obtained at the finger grips 33, or elsewhere along the metallicportion of the device. The device isthen attached tothe tunnel l8,preferably in a frictional manner, and this is preferably accomplishedafter the endoscopic device is in position withinv the body. By thenmanipulating the grasping member, the catheter may be engaged,

advanced, released, reengaged, and readvanced, so. as to accomplish astep-.by-step threading of the catheter, first through the nipples 29and 28, and then through the tunnel 18. It is to be observed that thisis all accomplished without the slightest danger of contaminating thesterile catheter. Even if the tube 20 brushes against the face of the.operator, or elsewhere, the enclosed catheter is. nevertheless protectedin an aseptic manner.

Themanipulation of the slidable member along the rod 26. is. extremelysimple, and the operator maysafely keep. his eye at the eyepiece l4, andkeep. his mind on the guidance of the inner end of. the catheter in thebody, without any danger of kinking, twisting, or contaminating thecatheter. The guiding effect of the rod 26' assures straightforwardproper advancement of the oatheter, step by step, into and through thetunnel l8 After the catheter has been entirely inserted, it is arelatively simple matter to disconnect either the tube 20 (byunscrewingthe nipple 2), or the entire device (by releasing the nipple 2 8). Ineither event, the tube or the device is withdrawn rearwardly over therear end of the catheter. In some. instances, it is also desirable towithdraw the endoscopic instrument, itself, rearwardly, over.theinsertedcatheter, thereby leaving the catheter alone in. the body,with its. inner end p pe y. itione and ts te end. projectin immt-bebo.fher m ra o h plu sins dei .3. we we. s. us he r. a e a e y simplematter, and a. specimen may safely-be dition.

In the event that the catheter is to be manipulated rearwardly duringthe operative procedure,

this may also be accomplished in an aseptic manner, by simplymanipulating thegrasping member in an opposite direction, 1. e., causingit to grasp the catheter toward the front, and releasing the catheterafter it has been retracted along the guide rod 26.

In Figures B8, I have illustrated a slight modification in which anelongated, flexible tube 31,

similar to the tube 20, is associated at its forward end with anelongated tubular member 38, the latter being split longitudinally, asat 39, to provide two opposed complementary jaws 40 and 42. These jawsare also elongated in a longitudinal direction and. are adapted toengage the catheter 4| in a releasablemanner as' the latter 20 projectsfrom the forward end of the tube 31.

The difference between the jaws 40 and 42 and .the jaws 34, previouslydescribed, is that it is preferable to construct the jaws 40 and 42 in aresilient manner, whereby they normally engage the catheter betweenthem. The' disengagement may be effected by providing finger grips 43and 44, each grip being carried by the remote jaw. That is, the grip 43is carried by .the jaw '40, while the grip 44 is carried by the jaw 42,as shown most clearly in Figure 8. By pressing upon these grips with thethumb and forefinger 45 and 46, as indicated in Figure 6, the

jaws 40 and 42 are caused to spread and thereby release the catheter.This permits the jaws to be moved longitudinally along the catheter intoa difi'erent position at which a new grasp may be obtained.

In using this device, the catheter is accommodated within the tube 31,as before, with its forward end projecting slightly from the for-' Wardend of the jaws 40, 42. The entire assembly may then be sterilized, andwhen it is withdrawn from the sterilizing chamber it may be handled withsafety without any danger of contaminating the catheter 4 i. The deviceis not attached to the catheter tunnel, as is the preferred embodiment,but the operator is enabled to feed the catheter forwardly through thetunnel by alternately releasing, shifting, and reengaging the catheterby means of the jaws. For example, the finger grips 43, 44 are pressedtogether to release the jaws; the entire device is slid rearwardly overthe catheter for about an inch; the finger grips are then released toenable the jaws to engage the catheter; and the catheter may then beforced forwardly through the tunnel for a corresponding distance. Thesesteps are then repeated until the desired amount of the catheter hasbeen inserted. The catheter-grasping device of this embodiment moveswith the tube 31 in each case, and not relative to the tube as in theconstruction of Figures l5. The objective, viz., to manipulate theadvancement and retraction of the catheter in an aseptic manner, is,however, the same and is accomplished with facility, despite the absenceof any guiding effect of a supporting rod of the character shown at 26.

It will be obvious that changes in the details herein described andillustrated, for the purpose of explaining the nature of my invention,may be made by those skilled in the art without departing from thespirit and scope of the invention as expressed in the appended claims.It is, therefore, intended that these details be interpreted asillustrative, and not in a limiting sense.

Having thus described my invention, and illustrated its use, what Iclaim as new and desire to secure by Letters Patent is 1'. Asterilizable device for aseptically controlling the movements of acatheter through a catheter tunnel, comprising an elongated, flexibletube adapted to accommodate the rearward portion of the catheter, and amanually controllable member carried by the forward end of said tube forreleasablygrasping the forward portion of the catheter, said membercomprising a pair of resilient jaws adapted to engage the catheterbetween them, and finger grips controlling the opening and closing ofsaid jaws.

2. A sterilizable device for aseptically controlling the movements of acatheter through a catheter tunnel, comprising an elongated, flexibletube adapted to accommodate the rearward portion of the catheter, and amanually controllable member carried by the forward end of said tube forreleasably grasping the forward portion of the catheter, said membercomprising a pair of resilient jaws normally engaging the catheterbetween them, and finger grips controlling the opening of said jaws.

3. A sterilizable device for aseptically controlling the movement of acatheter through a catheter tunnel, comprising an elongated, flexibletube adapted to accommodate the rearward portion of the catheter, and amanually controllable member carried by the forward end of said tube.

for releasably grasping the forward portion of the catheter, said membercomprising a pair of elongated, resilient jaws having complementarycylindrical grasping surfaces adapted to conform to and engage thecatheter between them, and finger grips carried by said jaws andcontrolling the opening and closing of said jaws.

4. A sterilizable device for aseptically controlling the movements of acathetrn through a 5. A sterilizable device for aseptically controllingthe movements of a catheter through a catheter tunnel, comprising anelongated, flexible tube adapted to accommodate the rearward portion ofthe catheter, and a manually controllable member carried by the forwardend of said tube for releasably grasping the forward portion of thecatheter, said member comprising an elongated, tubular element alignedwith said flexible tube and longitudinally split to provide a pair ofcomplementary elongated jaws adapted to engage the I catheter betweenthem.

6. A sterilizable device for aseptically controlling the movements of acatheter through a catheter tunnel, comprising an elongated, flexibletube adapted to accommodate the rearward portion of the catheter, amanually controllable member carried by the forward end of said tube forreleasably grasping the forward portion of the catheter, and means formounting said member so as to permit longitudinal movement thereofrelative to said tube.

7. A sterilizable device for aseptically controlling the movements of acatheter through a catheter tunnel, comprising an elongated, flexibletube adapted to accommodate the rearward portion of the catheter, amanually controllable membercarried by the forward end of said tube forreleasably grasping the forward portion of the catheter, means formounting said member so as to permit longitudinal reciprocations thereofrelative to said tube, and means for: guiding said reciprocations alonga predetermined direction forming a smooth continuation oi the axis ofsaid tube. V

8. A sterilizable device for aseptically'controlling the movements of acatheter through'a catheter tunnel, comprising an elongated flexibletube adapted to accommodate the rearward portion of the catheter, arigid, longitudinal supporting rod carried by the forward end of saidtube, and a manually controllable member slidably mounted on said rodand adapted to releasably grasp the forward portion otthe catheter.

9. A sterilizable device for aseptically controlling the movements of acatheter through a catheter tunnel, comprising an elongated, flexibletube adapted to accommodate the rearward portion of the catheter, asquared longitudinal guide rod carried by the forward end of said tube,and a manually controllable member for releasably grasping the forwardportion of the catheter, said member being slidably mounted on saidguide rod.

10. A sterilize-ble device for aseptically controlling the movements ofcatheter through a catheter tunnel, comprising an elongated, ilexi-- bletube adapted to accommodate the rearward portion of the catheter, arigid, longitudinal supporting rod carried by the forward end of tube, amanually controllable catheter-grasping member slidably mounted on saidrod, and means for securing said device at the forward portion of saidrod to the rear end of said tunnel.

11. A sterilizable device for aseptically controlling the movements of acatheter through a catheter tunnel, comprising an elongated, flexibletube adapted to accommodate the rearward portion of the catheter, arigid, longitudinalsupsaid of said rod and aligned with the axis of saidfiexii ble tube, said nipple being adapted to secure the device to therear end of said tunnel.

12. A sterilizable device for aseptically controlling the movements of acatheter through a catheter tunnel, comprising an elongated, flexibletube adapted to accommodate therearward portion of the catheter, asquared longitudinal guide rodcarried by the forward end of said tube,

a manually controllable catheter-grasping member slidably mounted onsaid guide rod, an attachment nipple carried bythe. forward end of saidrod and adapted to secure the device to the rear end of said tunnel,anda flexible bushing in said'nipple and aligned with the axis of saidflexible tube.

13.- A sterilizable device for aseptically controlling the movements ofa catheter through a catheter tunnel, comprising an. elongated, flexibletube adapted to accommodate the rearward portion of the catheter, asquared longitudinal guide rod carried by the forward end of said tube,a manually controllable catheter-grasping member slidably mounted onsaid guide rod, and an attachment nipple carried by the forward end ofsaid rod for securing the device to the rear end of said tunnel, saidcatheter-grasping member comprising a saddle engaging said rod, and apair of complementary jaws carried by said saddle.

14. In a device for aseptically controlling the movements of a catheterthrough a catheter tunnel, a guide rod, means at the forward end of therod for securing it to the rear end of said tunnel, meansat the rear endof the rod for sup porting the forward end of an elongated, flexibletube, and a catheter-grasping member car-

